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Improving outcomes following surgery for breast cancer

Shelley Potter Bridging Fellow

Dr Shelley Potter

17 January 2018

Clinical scientist Dr Shelley Potter is passionate about improving the lives of women with breast cancer. A key focus of her research is women undergoing breast reconstruction following a mastectomy, since there is a lack of reliable evidence to inform women’s choice of reconstruction surgery. An award from the EBI Bridging Fund provided her with the opportunity to pursue this work while completing her specialist surgical training.

Breast cancer affects around 54,000 women in the UK each year, and 40 per cent of these patients require a mastectomy. Breast reconstitution following a mastectomy can dramatically improve a woman’s quality of life, and ranges from simple procedures using an implant to more advanced techniques involving transferring tissue from the woman’s back or abdomen. 

Dr Potter first identified the need for more data from interviews with breast cancer patients as part of her PhD at the University of Bristol. This showed that women who had undergone breast reconstitution after a mastectomy felt they had been unable to choose what procedure would suit them best because of a lack of good-quality evidence. 

As a senior researcher at Bristol, Dr Potter is seeking to address this by exploring the feasibility of randomised controlled trials to assess the clinical success and cost-effectiveness of breast reconstruction. This involves randomly allocating participants either to the group receiving the treatment in question or to a control group receiving standard treatment (or placebo), to reduce bias when trying a new treatment. 

Until recently, there were methodological and cultural barriers to conducting randomised controlled trials in the field of breast reconstruction. But thanks to research advances and a more evidenced-based culture among breast reconstruction surgeons, such trials now look more feasible. 

Dr Potter has won a five-year National Institute for Health Research (NIHR) Clinician Scientist Fellowship award at Bristol to explore the best ways to measure the outcomes and costs of reconstructive breast surgery and determine whether it is possible to randomise patients into a trial comparing two types of implant-based surgery.

She won the award with the help of an EBI Bridging Fund at the end of an NIHR Academic Clinical Lectureship at Bristol’s Centre for Surgical Research (Royal College of Surgeons’ Trials Centre and Medical Research Council Methodology Hub). 

The NIHR Clinician Scientist Fellowship proposal grew out of her work for her PhD and the Academic Clinical Lecturer award. During this time she received an NIHR Research for Patient Benefit (RfPB) Principal Investigator Award and an Academy of Medical Sciences Starter Grant, in addition to winning national prizes, publishing a number of research papers and making numerous presentations. 

As well as allowing her to prepare the best case possible for the NIHR Clinician Scientist Fellowship, the EBI Bridging Fund enabled her to complete the RfPB grant, while undertaking a National Training Interface Group Oncoplastic Breast Surgery Fellowship at St Helen’s and Knowsley Teaching Hospitals NHS Trust, a centre of excellence for oncoplastic and reconstructive surgery in Liverpool. As a result she finished her specialist surgical training and became a consultant surgeon and senior lecturer. 

Dr Potter said, ‘I am extremely grateful for the opportunities and funding created by this EBI bridging award. It has been an invaluable opportunity to gain the specialist knowledge and skills to offer a comprehensive range of oncoplastic and reconstructive surgical techniques to women diagnosed with breast cancer, with the aim of improving outcomes. 

My experiences have informed and stimulated my research and allowed me to develop research ideas that address key uncertainties in reconstructive surgery that are important to patients and the surgical community. I have also had the chance to work with leading breast and plastic surgeons in specialist centres outside Bristol, which will facilitate collaboration as my research develops and grows.’

Further information

Find out more about Dr Potter’s research on the Bristol Medical School website.

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